The role of hormones in sepsis: an integrated overview with a focus on mitochondrial and immune cell dysfunction

Clin Sci (Lond). 2023 May 5;137(9):707-725. doi: 10.1042/CS20220709.

Abstract

Sepsis is a dysregulated host response to infection that results in life-threatening organ dysfunction. Virtually every body system can be affected by this syndrome to greater or lesser extents. Gene transcription and downstream pathways are either up- or downregulated, albeit with considerable fluctuation over the course of the patient's illness. This multi-system complexity contributes to a pathophysiology that remains to be fully elucidated. Consequentially, little progress has been made to date in developing new outcome-improving therapeutics. Endocrine alterations are well characterised in sepsis with variations in circulating blood levels and/or receptor resistance. However, little attention has been paid to an integrated view of how these hormonal changes impact upon the development of organ dysfunction and recovery. Here, we present a narrative review describing the impact of the altered endocrine system on mitochondrial dysfunction and immune suppression, two interlinked and key aspects of sepsis pathophysiology.

Keywords: hormones; immune response; mitochondria; organ dysfunction; sepsis; stress response.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Hormones
  • Humans
  • Mitochondria
  • Multiple Organ Failure*
  • Sepsis*

Substances

  • Hormones